September Williams' Bioethics Screen Reflections

12/03/2016

Director July Dash (Daughters of the Dust and Scratch Line) at the MVFF 39 October 14, 2016

As a member of the National Writers Union and affiliate of the International Federation of Journalists, it is my profound honor to represent the California Film Institute in presenting director Julie Dash the Mill Valley Film Festival Award. This award honors the excellence of her lifetime body of work.” —None of these words could I have imagined coming from my mouth. But, on October 12, 2016, that is what I said at the 39th Mill Valley film festival. MVFF is one of the longest running Film Festival’s in North America with an audience this year of more than 65,000.

Recently digitally remastered by the Coleman Library, director Dash’s DAUGHTERS OF THE DUST aesthetic remainsincomparable with a message persistently timely. An African American family prepares to leave their Gullah Island home. They and their descendants have lived on that land since long before the Emancipation Proclamation. Tensions between the power of the familiar and perils of a new existence are made abundantly clear by a matriarch. She is a first degree relative to those brought as slaves from Africa.

The re-released version ofDAUGHTERS OF THE DUST, screened at the MVFF39, was preceded by the premiere of Dash’s provocative new short film, STANDING @ THE SCRATCH LINE. This new work is a part of the Great Migration Project. It lyrically traces the arrival of the first Africans on the Gullah Island shore their generations of migration from the Gullah Geechee Lowcountry to Philadelphia, PA. The film links the survival of a people to the strengths of the sacred architecture of African American Churches.

Filmmaker Julie Dash’s screen voice is an offspring of the “LA Rebellion”. The LA Rebellion creative movement emerged from the UCLA School of Theater, Film and Television during the late 1960s and 1970s. The Rebellion was, and is, the bard of complex justice issues, while also an anti-venom for racism and classism.

Twenty years after the LA Rebellion, in 1991, internationally recognized, Julie Dash’s DAUGHTERS OF THE DUST, was the first feature-length film by an African American woman with United States theatrical release. The film coincided with a period when we, in clinical medical ethics, were defining the importance of cross-cultural communication in medicine — particularly at the edges of life — birth and death.

The battle was to get an understanding of race class and culture into the medical curriculum.

In a real way Ms. Dash’s work help to combat health disparity across race, class and culture. Her's is an anthropological short hand bundling the reality of what had before been like talking only about the reflection of stars — Now, one can actually show the celestial body of cultural complexity to colleagues and say, “ This is part of what you are working with when you diagnose a person with a life threatening illness, with its fears, attendant loss of family and culture.” Director Julie Dash manages to demonstrate that a culture can be simultaneously different from others, while expressing universal concerns.

Other works by Ms. Dash are THE ROSA PARKS STORY, INCOGNITO, FUNNY VALENTINES, LOVE SONG and SUBWAY STORIES. Coming soon is her film TRAVEL NOTES OF A GEECHEE GIRL, about writer- actor-griot-culinary anthropologist Vertamae Smart-Grosvenor.

The opening and closing films of the 39th Mill Valley Film Festival were both romances, different from one another as night and day. The starting film was about elusive love. Written and directed by Damien Chazelle, LA LA LAND is a romantic musical whose comedic elements facilitate the dramatic. It feels like a cross between Preston Sturges' Sullivan’s Travels and Singing in the Rain. LA LA LAND’s enduring impression is a sensibility for people defined by creative aspirations.

The title, LA LA LAND, is a double entendre. The more concrete allusion calls up the musical note ‘La,’ as in the Rogers and Hammerstein’s Sound of Music, “La is just to follow so.” What marks the feature as a high concept film is the other meaning— the rarely attainable, though ubiquitous, high hopes for creative success in the unreal Los Angeles — while moving into the developmental stage of adult intimacy.Ryan Gosling and Emma Stone act (and dance) in subtle ways. Their performances are beyond being the coat hangers for music, choreography, and the exquisite mostly on location scenery. Complexity of the main characters is clarified by the arrival of the co-star, John Legend, at the mid-point of the film. He draws the arrow telling Gosling’s character, a musician, that there is only one path to follow. That way pushes him away from his lover, Stone, a writer.The opening scene of La La Land is set squarely in one of the plagues of Los Angeles life. The setting, time, and characters shout that you are entering a cross cultural zone, where fantasy is allowed. Replete with classic musical film homages, Justin Hurwitz’s score shares the passion of Leonard Bernstein’s West Side Story, rather than the showmanship of an Arthur Freed musical. We quickly learn the rival gangs are the tensions between the creative aspirations in the heads of each star, fighting for attention and love.Hurwitz’s uses the advantage of Jazz, Blues and Rock & Roll, having been racially integrated after the glory days of the classic 1940s and 50s musicals, to broaden the range of emotions. The love theme of La La Land represents the magical inner voice of the protagonist’s relationship. When you hear this film’s music forty years from now, be forewarned, if it made you cry this year, it will then. How does a Romantic Musical help Bioethics?LA LA LAND shows tension between the ‘competing goods’ of the noble aspirations of intimacy and creativity. The film is a captivating metaphor, showing a version of goal attainment reached through an unexpected narrative path. Other creative intents are not unlike those of a surgeon in training, or a doctoral student dreaming to cure global warming, in conflict with raising their families. The shared challenge is not aiming for competence but greatness.Casuistry can exist beyond ‘the word.’ When visuals are added to written narratives additional neuropsychological features join ‘the case’ presented. Even a single photograph is a visual narrative. Music, as in LA LA Land, is interpreted even more subjectively than visual cues. “Research into the bodily basis of musical meaning has focused on conceptual metaphor and image theory but the processes whereby embodied experience becomes relevant to music conceptualization remains largely unexplained.” We do not know exactly why the blues is cathartic, for some and not others though we know it is so. Related are examples where sound, say of a bottle of soap falling, has been known to result in smelling soap for some people sans attendant visual stimulus. It is clear that the sound of music has a narrative language specific to its own form. The core of the “musical mimetic hypothesis” suggests we understand sounds in comparison to sounds we have made ourselves, and this process of comparison involves tacit imitation, or mimetic participation, which in turn draws on the prior embodied experience of sound production. That is second hearing draws a reaction to the first hearing of the primary sound and stimulates a similar feeling and physical response. Each note delves into the influence that note has had in one’s life. If this is true, clearly the Casuistic case forLA LA LANDis maximized by the music itself.LA LA LAND is a choreography of the mind, expressed by over a hundred dancers, actors and musicians along with nearly as many crew. It takes a lot of nerve and talent to wield such a team. Luckily for the audience composer Hurwitz choreographer Mandy Moore (Silver Lining's Playbook), cinematographer Linus Sandgren (American Hustle), and writer-director Damien Chazelle are chutzpah endowed. LA LA LAND is a film to watch and hear. It opens in theaters December 16, 2016.Casuistry uses cases or narratives to illustrate ethical conflicts and their resolutions. Despite the potential abuse of Casuistry, Medicine and Law are both fields where cases are applied to ethical decision making. Religious books, literature, drama and film can also be used in Casuistic analysis of moral dilemmas. At its core, Casuistry requires solving a second unrelated case by using the logic of the original narrative — so stories need not be medical or science based to argue Bioethics.

10/14/2016

Hidden Figures is a fiction film adapted from Margo Lee Shetterly’s nonfiction book by the same name. It is about a group of African American women who are mathematicians. As if that were not exceptional enough, they work for the National Aeronautics and Space Administration (NASA) at Langley, Virginia. But— wait for it— in the early 1960s. A true story—

This movie is an homage to women taking their rightful place in the history of science, technology, engineering and maths (STEM). However, now understanding ‘art’ unleashes scientific capacity — this film about Sci-tech is also about STEAM. It is no accident most of the women depicted in the book and film were educated at Historically Black Colleges and Universities known then, and now, for pushing students to excellence in all fields.

Hidden Figures focuses on a small pertinent aspect of the source book— how a cadre of Black women helped launch the Mercury 7 astronauts. Set in 1961, the back drop is a pivotal period in the United States civil rights struggle, the imbalances of the Cold War, and the peri-WWII legacy pushing women into the previously male dominated work force. The collaboration between the characters in the film mirrors that of the production team which developed the project.

The California Film Institute, parent of the Mill Valley Film Festival (MVFF), has an ongoing initiative to improve the status of women behind the camera in the film industry. The initiative is called Mind the Gap. At MVFF39, October 8, 2016, Mind the Gap programing provided a sneak preview and panel dialog about Hidden Figures. Film professionals working on the project were present for a chat hosted by Variety’s Melina Saval.Participantsincluded Elizabeth Gabler (president, Fox 2000), Mimi Valdez (Executive Producer), Mandy Walker (director of photography), and Marissa Paiva (Vice President, Fox 2000). These production partners and crew are deeply committed to providing a platform for the best films about and by women in a racially, culturally and gender expansive context. They are being the change they want to see.

The phrase that comes to mind about Hidden Figures is “When you Strike Woman you strike rock.” That’s a calculated intertextual reference to women’s struggle inserted by the filmmakers. The screenwriter, Allison Schroeder, and director of photography Mandy Walker along with Melfi, made fine compositional and emotional choices. Among those choosing a well informed visual aesthetic. DP Walker explained, during the Mind the Gap session, research included exploring the documentary seriesEyes on the Prize;works of Concerned Photographer Gordon Parks; and those of Student Nonviolent Coordinating Committee photographer Danny Lyons

HIDDEN FIGURES is a high concept film, but not unbearably weighted. Instead, writer Director Theodore Melfi’s exquisite ensemble animates this inspirational focused story with humor as well as purpose. These are after all the things daily helping people survive oppression. Among the actors are Taraji P. Henson, Octavia Spencer, Janelle Monáe, Kevin Costner, Kirsten Dunst, and Jim Parsons. For my money — it is a Peace Genre film.

HIDDEN FIGURES is important because it speaks to the lives of ordinary working people. In this case in a Black American community. They are not the most deprived, not the wealthiest. Depicting social and environmental justice only in the context of brutality desensitizes viewers to the subtle degradation which wears away at a persons potential. Violence brings in the box office, but where are the rest of the stories? Is the only drive for a better life defense of ones lowest level of the Maslow Scale — food and shelter? Evidence suggest otherwise and so does HIDDEN FIGURES.

There is an on going dialog between film and social responsibility. Part of this dialog is stimulated by the technology of the art of film and the function of the brain. Our movie memory seems to go where our actual memory is stored. Over time our life understanding seems blurred with the stories and films we have seen mixed with those we have lived. That’s how film works at its best. We know what resonates consciously but we are less sure of the unconscious.

How isHidden Figuresgood for understanding Bioethics? The tendency is to focus on the justice or injustice issues raised by the film and its times. The more bioethics relevant dialog occurs around beneficence — in the use of science and technology and film. Beneficence is, for simplicity sake — doing good with what we know, knowing what we do not know, and expanding knowledge through research. More concisely, beneficence is equivalent to scientific integrity. The film’s plot quickly ranks scientific beneficence concerns over autonomy or justice.

The main character runs the risk of loosing her job and castigating other sisters in the workplace, by expressing her considerable mathematical capacity. The choices she makes are moral choices driven by good science. Just as in all applied bioethics, like clinical medicine, understanding the obligation to do good with science, including the science of film, yields decisions which also come closer to achieving autonomy and justice.

Hidden Figures adds grist to US Congressional Caucus on STEAM ( Science, Technology, Engineering, Arts and Math.) The hop is this initiative will create the next generation of brilliance in pure and applied scientist — one with consciousness at the forefront, and improved representation across race, class, gender and culture. Most importantly, Hidden Figures supports scientific exploration in service of honesty. Enough well developed minds may eventually help us understand — the full potential of the art and science of film.

Support Hidden Figures and other films in the peace genre by seeing it in the theater rated PG, Christmas Day 2016, in 13 cities. The full roll out will be in January 2017.

5/11/2016

Concussion is a documentary biography about medical science’s triumph over a social and corporate conspiracy to suppress evidence of a serious preventable disease. Forensic pathologist, Bennett Omalu, MD, discovered a pathognomonic sign confirming chronic traumatic encephalopathy (CTE). He happened to find it in a cluster of professional football players during autopsies. Concussion was written and directed by Peter Landesman, who managed a riveting story pace, despite most of the visuals occurring in the inglorious world of microscopes and morgues —done to death on television.

Will Smith’s Dr. Omalu in the lead role is a flawless interpretation of African born Omalu. The supporting cast includes Alec Baldwin, Gugu Mbatha-Raw, Luke Wilson, Albert Brooks, Adewale Akinnuoye-Agbaje and others. Ridley Scott is the principle producer. This is a heavy hitter production. Though several Black film awards recognized the work, few others have. Perhaps this is because the lead character is a Black man who is not blowing up anything, except the gladiator culture we like to call Football.

Concussion is a gentle story where a brilliant man driven by unflappable moral instinct does the right thing. Others join him, many kicking and screaming, eventually recognizing the effects of repetitive concussions in football and so elsewhere. The fact that this bold faced David and Goliath story, taking on the industry of Football, has had such a poor reception is a shocking, though not a surprising, eyebrow raising event. As the old word play goes, “Denial is more than a river in Africa.”

Traumatic Brain Injuries from bomb blast during war, car crashes, playing football and other sports, share similar features.(See Going the Distance on this blog.) Exploring Concussion makes viewers understand the randomness of traumatic brain injury (TBI) especially with all those shots of players on the film colliding, pulled from game stock footage. It is similar to watching car accidents from a helicopter.

The effects of CTE develop progressively over a long latent period, often 1-1.5 decades into a football career. TBI goes to dementia more often than not if, a person lives long enough. Dementia is certainly the insidious boogyman many adults in the wealthiest nations most fear.

If syphilis was considered the great masquerader during the first half of the twentieth century, and AIDS that of the latter half, TBI is vying for the role in this millennium.

The emergency room is often where patients with traumatic injuries are first seen. How fast was the vehicle moving? What did it hit? These are among the first questions asked by ER clinicians. They are quickly estimating the amount of G-Force the person has been subjected to upon encountering an immovable object, like another car, or another players football helmet.

When patients leave the ER, they often are relieved by the proclamation that a “brain scan” showed no bleeding. They do not understand the comment does not mean brain injury is absent. It only means one kind of brain injury has not been seen, bleeding. Bleeding is an acute brain injury which is treatable if recognized. CTE so far is not treatable, only preventable.

When the injured ER patient is they told to come back if they vomit, have unequal pupils, and to have someone around to do “neuro checks,” they do not understand, these are signs of brain swelling from edema or bleeding. The complications of repetitive, or single concussions do not usually manifest immediately and tend to be very subtle initially. People need to be told watch for those signs down the line and seek clinical assistance even if distant for the incident of injury.

G-Forces of 50G or greater against a head causes a concussion. The outcome of that concussion only becomes clear overtime. Football players routinely suffer greater than 90G hits repetitively. The luke warm public response to the film Concussion reflects the reality that this “message film” convey’s at least one notion so terrifying that most parents and football fans, do not want to hear. The most poignant scene of the film is the final one, when you see it, you will understand why.

Recent science and trauma protocols suggest neurological logical rest following brain injury improves late outcomes. Rest is a more appropriate instruction than, ”you are fine.” In bioethics, beneficence or doing good with the knowledge of science, out ranks both autonomy

2/05/2016

The 2015 film, Sembene!, is a documentary about the late writer-director, Ousman Sembene, (1923-2007). His bioethics relevant filmography begins with his first film, Black Girl (1966) and finishes with his last work, Moolaadé (2004). The documentary, Sembene!, is directed by Samba Gadjigo and Jason Silverman. Samba was Sembene’s friend, colleague, and biographer. Sembene! was screened at the 38th Mill Valley Festival in October 2015. A stroke of programming genius also allowed patrons to view the recently restored Black Girl. Black Girl is one of the World Cinema projects preserved by Martin Scorsese’s Film Foundation, a testament to Ousman Sembene’s stature as African Cinema’s founder.

The structure of the movie Sembene! is formed from clips of the visually sublime, narratively sleek dramas created by the legendary filmmaker. Circumstances resulting in the United Nations Declaration of Human Rights (UNDHR) parallel Sembene’s life and work. Conscripted into the French Colonial Army, the artist subsequently served in the Free French Forces during WWII. In 1944, a massacre perpetrated by White Colonial French soldiers resulted in the deaths of somewhere between 70 and 300 Black French African troops who had been German prisoners of war, returned to their home continent. Sembene’s film about the massacre, Camp Thiaroyre (1988), is one of his most stinging indictments of colonialism, so much so it was banned in France until 2005.

Forced by economics to migrate to France after the war, he eventually became a Marseille dockhand. He found a home among French trade unionists, communists, anti-colonial and intellectual progressives. His back actually broken from lifting cargo, he was confined to bed. During his long recovery he read voraciously — existentialism, rebellion and the works of the Harlem Renaissance. Emerging from that period a writer, he also grasped cinema’s potential, especially for those without alphanumeric literacy.

Raised by his grandmother, Sembene found exquisite narrative focus in his films about women and their oppression. The documentary, Sembene!, pays special attention to the bookends of the director’s film career, Black Girl and Moolaadé. Black Girl is about a Senegalese woman who worked in Africa as a nanny for a wealthy ex-patriot French family. She agrees to join them in France when they leave Africa. On the nanny’s arrival in Europe, the previously more affable employers, now on their home turf, turn the tables. The Senegalese nanny’s chores are expanded. A domestic slave, she is stripped of all dignity and the capacity to return home.

Since 1966, when Black Girl was made, 64 Million women, 15% being children, work as domestics without contracts, guarantees of labor standards, or redress of injustices. These, and the rising documentation of physical and sexual abuse, resulted in action by the International Labor Organization (ILO). In 2013, the ILO entered into force an international convention, C19, which protects domestic workers from slavery. At this writing, twenty nations have ratified the convention. The United States, though disproportionately hiring foreign born domestics, has not ratified. Sembene’s politically sophisticated film pre-empted the need for the ILO convention by a half century.

2/04/2016

Sembene! is a documentary co-directed by Samba Gadjigo and Jason Silverman. The filmmaking duo uses Sembene’s screen works to bracket the life events of African cinema’s founder. The ultimate illustration of capacity for complex socially relevant, visually compelling cinema lay in Sembene’s 2004 final film, Moolaadé (Magical Protection). This is a heart wrenching story of a woman named Collé living in a fictional, locked in time, Burkina Faso village.

Collé’s is a polygamous family. She resists her daughter having female genital mutilation (FGM), colloquially called “cutting.” She is horrified that a relative secretly ‘cut’ her youngest daughter. The mother has been steadfast in her refusal of cutting since her children were born. Now, under the pressure of impending marriage, even the bride to be elder daughter wants her mother to capitulate. The mother still refuses though, causing the bride to social ridicule. Collé’s ostracism and beatings are her reward for redefining the cultural moral high ground.

Gradually winning a few other village women over, they often gather at the radio where new thoughts are introduced by journalism and music. The men in the village are not oblivious to the radio's support of women’s rebellious acts. The glory of Moolaadé is that the fight against female genital mutilation arises from the same culture from which the horror comes. Collé fights to change the archaism within her own community. Medicine has been served well when recognizing “The people with the problem very often hold within them the solution.”

Desert Flower is a film adapted from the book of the same name by Somali born writer and human rights worker, Waris Dari. It shows the evolution of the author’s own understanding and isolation because of her FGM. Her courage is catalyzed by her European immigration and moral shifts.

If we believe that principles in ethical decision making are weighted; and that which is not medically indicated cannot be beneficent; real life protagonists like Collé are not well served when medical practitioners consider providing ‘female circumcision.' One could argue that male circumcision is equally archaic and medically not indicated. However, incidences of known and common negative sequela are not well documented in male circumcision.

FGM is like the Nazi Sea Water experiments. The Nuremberg Code, drawn from the Nuremberg Trials is, along with the United Nations Declaration of Human Rights, the historical underpinning of modern bioethics. The former established two major violations of human research and medical care. One was research without a scientific hypothesis. The other is doing things that don’t need to be done. The classic example is the sea water experiments. There was no need to only give people sea water to drink, not for research or for their care. Centuries of ship's logs document the effects of drinking seawater. Another example is a 40 year observational study of the natural history of syphilis on 300 Black men in Alabama when it had long been studied in Oslo years before.

Emerging from stigma, the documentation of the negative effects of FGM, provided by those who have had it, establishes a clear pattern. Gynecologist Dr Rosemary Mburu from the World AIDS Campaign in Kenya, reports “female genital cutting” in her work. She estimates that while 15% of cut girls die of the excessive loss of blood or wound infection, survivors have lifelong pain, including: while having sex, urinating or working.

Mary Nyangweso Wangila's 2014 book, Female Genital Cutting in Industrialized Countries: Mutilation or Cultural Tradition?, provides an excellent analysis. Mary makes a strong case for not pitting culture against the human consciousness movement of the last 200 years. Slavery was once an acceptable norm too, but you can’t begin to stop it if no one agrees to try. There we are, full circle back at Sembene’s first film, Black Girl and the issue of domestic slavery.

Both of Sembene’s bookend films, like the story directors Samba Gadjigo and Jason Silverman portray, deal with personhood as included in each aspect of the UN Declaration of Human Rights. Sembene is both honored and dishonored by being called the father of African Cinema… he is so much more than that.